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For doctors‘Why am I not losing weight on keto?’
, medical content by Bitten Jonsson, RN
in Addiction, Q&A, Sugar/fructose 
Why are you not losing any weight on a keto diet? And how do you stop yourself from eating out of anger?
These questions are answered this week by our food-addiction expert, Bitten Jonsson, RN:
Eating keto with no results
I followed keto between May 2019 and Dec 2019, and slowly lost 20 pounds (9 kilos). Then there were Christmas parties and I went to Florida for three months, which lead me to fall off the keto wagon. I went back on keto with enthusiasm and vigor on May 4, 2020 and have lost nothing. It’s very discouraging, to say the least.
I go up a pound, and the next day go down a pound. I don’t understand. And believe me, I wouldn’t complain if I was cheating.
Perplexed and disappointed, I forge ahead. I’m anaemic and take an iron pill every two days, which causes constipation so I need to take laxatives. Also have a very dry mouth due to blood pressure and cholesterol meds so I take Fishermen’s Friend lozenges that alleviate slightly.
Please help me!
Mary
Mary,
I’m sad to say that this is a very common problem. To go on and off keto (or any diet) like this can be problematic for our metabolism. The time from 4th of May until now is in my world a very short time. If you are a sugar addict, then your biochemistry is even more sensitive than others. You’ll need resilience and patience.
There are some things you could try. One thing I recommend is nose-breathing. It might sound far-fetched but in my experience, I think it works. The way I see it, if we are stressed we tend to mouth breathe and “over breathe”, which also results in dry mouth and more stress. Go to this link for more information about nose-breathing. Plus, it’s an easy intervention with no real downside to trying it.
Going up and down one pound is, I think, only caused by a shift in fluids.
Do you do any physical activity? I suggest walking on a daily basis to increase insulin sensitivity. I also suggest you join our support group on Facebook to learn more about sugar addiction and how to start implementing other recovery tools instead of only focusing on weight loss. Sometimes being too focused on only that causes stress.
Last, you might want to contact a professional that works with biochemical repair, see the list here.
Keep going, things will get better,
Bitten
Eating out of anger
I need help.
I started with the keto diet last year and lost 15 pounds (7 kilos), which I was very happy about.
The problem I have is that I use food to cope with frustrations. I work from home and do love my job, even though some customers make it difficult to get off in the morning.
My problem is my husband, his way of acting makes me fall off the wagon. Every time I ask a question or make a comment, he responds with a nasty attitude. Then I get so upset that I eat and also drink.
What can I do to control this anger and my weight? I want to mention that I’m 54 years old, which makes weight loss more difficult.
Myrtha
Myrtha,
I really do understand how difficult this is. I feel with you.
First of all, I want to congratulate you on starting a healthy keto lifestyle and losing weight.
Being addicted to sugar, i.e always really wanting our “drug food” sets things up in very strange ways.
You might not want to hear this but think about it in this way: what if you use your husband’s behavior as an excuse to eat? Ask yourself why you give him this power over your health. I know, these are very tough questions to ponder, but our addiction does strange things to us.
Do you keep drug food in the house? Please remove that first thing, and if your husband buys them, see them as his, not yours.
I hear that you need a lot of knowledge. Read Dr. Vera Tarman’s book Food Junkies to understand our addicted brain, then join our support group on Facebook. Many in this group will identify with you and share tools they’ve learned along the way to deal with situations like this.
Warm regards,
Bitten
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So either fast for three days or eat only protein in a protein sparing modified fast. My ma has lost 80lbs doing it.
Kathleen Young, I don't believe keto is a con at all. I've lost 27kgm fixed my diabetes/dyslipidaemia. My querie relates to why keto STOPS working after it's been so effective
If you have been on low-caloric diets or eaten crap for decades, your body doesn’t care for losing weight to begin with, it prefers to heal,
When my patients stall after losing the first few pounds, which I think is flushed out oedema from the lowered insulin, I explain it like a long trip with your car.
As we aren’t newborns, our car might be 40+, 50+ years old, and when we prepare for a very long trip, what is important? A shiny new colour (= weight loss)? Or wouldn’t you rather get the engine, breaks etc checked and put in order (building bone mass, healing muscles and organ function)?
Also, being keto shouldn’t equate to eating 6 times a day with snacking, even keto snacks, as everything you eat triggers SOME insulin secretion. And you know that stops you from burning fat for 12 hours.
If your stall goes beyond 8 weeks despite 3 meals only (each finished within an hour and not continuing for hours), I would encourage you to do 36 or 42 hour fasts, building it up slowly, first skipping breakfast (easy), then lunch, managing 24 hours a couple of times.
May I recommend podcasts featuring Megan Ramos? She’s brilliant.
I appreciate Bitten very much, but answering every problem with Facebook groups seems a tad too much ‘one-size-fits-all’ to me.
It’s not a bad thing to transform the energy from body fat into bone density. Especially for a woman around menopause.
Wish you luck and continue to pimp that car of yours until you are at your destination.
I started keto 3 months ago. I lost only 4 kgs. I'm an vegeterian and used to have eggs but no meat. I used to have butter coffee in morning with 2 eggs for breakfast and salad for lunch and roasted veggies or cheese omlette or egg plant (roasted in olive oil) for dinner. I also used to have avacado during lunch or as evening snack. Can someone please help me.
butter in your coffee PLUS 2 eggs for breakfast is a lot. I would skip the butter in the coffee for starters. Let's say you would burn 100 g of fat from storage in your body, but you add 80 g of fat through your nutrition, you can only burn 20 g of your own fat. That's putting it a bit simplified, I know, just to give you an idea.
When I started keto years ago, I was in a similar spot. I had all meals and all snacks. I didn't lose a single g in weight, but oh did I feel fantastic and healthy for the first time in years.
Then I let go of the butter in my coffee, in fact haven't done that for several years now. Then I noticed, there was no need for snacking anymore. Then I lost my appetite for breakfast. Without even trying I was down to OMAD (One Meal A Day), and now I do 42-hour-fasts 2-3 times a week. But on the days I eat, I have breakfast, lunch and dinner. And not teeny tiny portions. I totally go for it.
Don't be discouraged. If you still have that huge appetite for fat, I suppose your body needs it (see my comment above; it's quite possible your body holds on to weight to repair some structures, but not necessarily fat; forget the scales).
If everything else fails, do yourself a favour and read Dr. Fung's "The complete guide to fasting" or his latest "Life in the fasting lane", which is co-written by Megan Ramos and a patient.
From what I have observed on myself, my family, and countless patients, you are doing just fine. Don't give up. It sounds crazy, but I'm a different keto-eater every 6 months. Sometimes I take an effort and change things up, sometimes my body does so instinctively.
I think that when starting a keto diet, you need to eat a lot of fat to send a strong message to your body "hey, use fat for energy from now on", but once you have become "fat adapted", then it's better to eat just enough fat to feel satisfied and not hungry in order to use your stored body fat for energy.
We haven’t survived for more than 200.000 years for nothing.
I’ve learned one thing in particular: you need to stay flexible. As I’m sure caveman did. It’s food. Not a religion.
Caveman surely had to fast from time to time, not by choice, but because there was no option. That kept him alert and tough, do he could survive.
Which he did mostly on keto-friendly food. And although fruit as we know it today is certainly far sweeter than 200.000 years ago, I would bet honey was, well, sweet as honey. And I am absolutely sure, caveman didn’t think, “Nah, I can’t have that, I need to stay in ketosis.” So he was possibly paleo whenever possible.
Fasting - Ketosis - Paleo are for me natural states of a human being.
I have great respect for Ms Jonssonn but I found that FB group to be a toxic place and the book is 'Meh' if you get the concept of food addiction anyway.
Still no real discussion of why keto stops working (not stall) or is just ineffective for some who go back to it after a break. Also I'm starting to see the same old attitudes of "it's not the advice, you just can't be doing it right" we've had from the orthodoxy. I'm a retired physician (turned farmer). I understand perfectly (better than many young docs because we were actually taught nutritional biochem in my day).
I cut up and wash e.g. broccoli, carrots, etc. and freeze jars with homemade sauces/bolognese.
Megan Ramos has a new Youtube Channel, The Fasting Method, and in one video she says, when it gets tough, she tells herself "I can have that tomorrow." For me, that's a gamechanger.
Reframe it. Fasting is not a punishment, it's a privilege. And when you crave something, it's not out of reach. You can have it tomorrow.
We still don't have any suggestions as to why keto stops working when it worked fine in the past, beyond 'you're broken' (but clearly weren't in your first two years on ket) or 'you're obviously not doing as you're told' (the latter which sound suspiciously like the excuse orthodox dietary advisers favour).
Here is our guide to a healthy vegetarian keto diet. https://www.dietdoctor.com/low-carb/keto/vegetarian
Have you checked the ingredients in the Fisherman’s Friend lozenges? Some kinda have sugar.